CONTROVERSIES IN THE SURGICAL THERAPY OF DIFFERENTIATED THYROID CARCINOMA: A REPLICATION STUDY REVIEWING 32 CASES

Document Type : Original Article

Authors

1 Department of surgery, teaching institutes & hospitals

2 Department of surgery, Ain shams University

Abstract

Objective: reevaluation of experience with total versus near total thyroidectomy(TT)in treatment of differentiated thyroid 
carcinoma. 
Design: 32 cases of differentiated thyroid carcinoma(21 papillary and 11 follicular) were allocated to receive either total 
thyroidectomy TT or near total thyroidectomy(NTT)from 1994 through 1997. In TT group, thyroid bed biopsies were taken intraoperatively and the postoperative RAI131 study was assessed to evaluate thoroghness of TT, also extensive 
histopathologc examination of the contralateral lobe was done to detect multicentric foci. Patients were followed up 
clinically, biochemically and radiologically to detect complications and recurrences. 
Results: In TT group, 15of16 cases(93.8%)showed residual uptake in the neck. Also thyroid bed biopsies revealed thyroid 
tissue in 12(75%), and contralateral lobe revealed cancerous foci in 6(37.5%). 4 of TT group(25%)developed permanent 
hypoparathyroidism and one developed permanent RLN palsy. 
In NTT group one developed transient hypoparathyroidism and one developed RLN palsy. 7 cases(20.8%)developed 
recurrences, 3 in TT group and 4 in NTT group. And 5(15.6%)have died during follow up period, 2 in TT group and 3 in NTT group, all were follicular carcinomas. All cases with papillary carcinoma are still alive. 
Conclusion: TT Vs NTT appear to bear no significant difference regarding recurrences and overall survival, despite an 
increased rate of complications in case of TT. 

Keywords

The Egyptian Journal of Surgery
Volume 23, Issue 4
October 2004
Pages 359-365

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